Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 7.3x130MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605039
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x130mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605092
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x130mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605092
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x135MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605040
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

SCREW CANN 7.3x135MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605040
Hospital Revenue Code	278
Min. Negotiated Rate	$26.44
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$26.44
Rate for Payer: Wellpoint Medicaid Managed Care	$29.07

SCREW CANN 7.3x140MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605041
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW CANN 7.3x140MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605041
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW CANN 7.3x145MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605042
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW CANN 7.3x145MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605042
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW CANN 7.3x150MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605043
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

SCREW CANN 7.3x150MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605043
Hospital Revenue Code	278
Min. Negotiated Rate	$26.44
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$26.44
Rate for Payer: Wellpoint Medicaid Managed Care	$29.07

SCREW CANN 7.3x20mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605069
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x20mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605069
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x25mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605070
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x25mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605070
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x30MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605019
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x30MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605019
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x30mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605071
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x30mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605071
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x35MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605020
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x35MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605020
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x35mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605072
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 7.3x35mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605072
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x40MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605021
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 7.3x40MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605021
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

Know your out-of-pocket cost for care.

All Charges